title: Remote ischemic preconditioning reduces cardiac troponin I release in cardiac surgery: a meta-analysis.
abstract: OBJECTIVE
  To determine whether remote ischemic preconditioning (RIPC) reduces myocardial injury, mortality, morbidity, and resource utilization in cardiac surgery.
  
  
  METHODS
  Meta-analysis of controlled clinical trials. The primary outcome was cardiac troponin I (cTnI) concentrations. Secondary outcomes included cardiac troponin T (cTnT) concentrations, myocardial infarction, stroke, renal failure requiring hemodialysis, atrial fibrillation, inotropic score, mechanical ventilation time, length of intensive care unit stay, length of hospital stay, and death.
  
  
  METHODS
  University hospitals.
  
  
  METHODS
  Adult and pediatric patients undergoing cardiac surgery, including coronary artery bypass grafting, valve procedures, and correction of congenital cardiac anomalies.
  
  
  METHODS
  Remote ischemic preconditioning through limb ischemia.
  
  
  RESULTS
  Nineteen randomized trials involving 1,235 patients were included in the meta-analysis. The cTnI concentrations at 6 (or 4-8) hours postoperatively and the total cTnI released after surgery showed a statistically significant reduction in the RIPC group compared with a control group (weighted mean difference [WMD] -2.03 ug/L, 95% confidence interval [CI] -3.25 to -0.82 ug/L, p = 0.001; WMD -65.74 ug/L*h, 95% CI -107.88 to -23.61 ug/L*h, p = 0.002, respectively). There were no differences in mortality, morbidity, and resource utilization between groups.
  
  
  CONCLUSIONS
  Current evidence suggests that RIPC reduces cardiac troponin I release in patients undergoing cardiac surgery. The clinical significance of these observations merits further investigation.
authors.affiliation: Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Lijing
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. Electronic address: guyanwang2006@163.com.
authors.forename: Guyan
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Yingjie
authors.initials: Y
authors.lastname: Du
authors.affiliation: Department of Cardiopulmonary Bypass, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Bingyang
authors.initials: B
authors.lastname: Ji
authors.affiliation: Department of Cardiac Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Zheng
mesh_terms: D006348:Cardiac Surgical Procedures / Q000379:methods*; D006801:Humans; D019157:Ischemic Preconditioning, Myocardial / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D019210:Troponin I / Q000378:metabolism*
chemical_list: D019210:Troponin I
keywords: cardiac; myocardial injury; myocardial protection; preconditioning; remote ischemic preconditioning